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APPLICATIL-4 FOR CONSTRUC7.43N PERMIT�W <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 9B201 •259-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRESS: 9- f;i c-4m&tzA 5i4 r ^�A/-L l'(-d z f t/Ga�o t>-,`Iha- WA-ej eve7ze7r- <br />OWNE;. MAILADDRESS CITY 71P PI.ONE <br />fi» iv_v err- vie- Li l *Q Z ucrr- /1" U/I yg Zeys — <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />h'A . --- Y/1/. 4,-2 . /19Z Z. <br />5 CITY <br />• ��Ce iIAN/YtS' ' e v • c. u. __ _ <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY I1P PHONE STATE LICENSE e <br />aslyrs /So�lueu� i�i� Zolr 775 4400 <br />..........................�.nn wn ennao cc CITY ZIP PHONE STALE LICENSE T <br />PLUMBING ONTnA TOR MAIL ADDRESS CRY ZIP PHONE STATE LICENSE T <br />CONTRACT PRICY F WORK 1AA1Gf+ft ` <br />4- HEATING SYSTEM: ❑GAS LJ ELECTRIC ❑ <br />//Z. Ooz- — <br />DESCRIBE WORK AND SCUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <br />�W ELY i` �. ,flew• !�i• `C. L(lA L( til c� Loc >K <br />I / <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />X>�r5 / /r_ui F K µY s <br />GGG i L Alter <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />PROPOSE USE OF BUILDING <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LEGAL DESCRIPTION OF PROPER" (SHOWN BELOW OR ATTACH TWO COPIES) <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />LOT BLOCK DF <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />PARCEL TAK I.O. NUMBER <br />:/N'JiLt — <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />�� <br />GATE <br />SIGNAT <br />CITY BUSINESS LICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />OF EQUIPMENT FEE <br />NO.WE— <br />WATER CLOSET (TOILET) <br />' <br />DLG UNITS <br />'BATHTUBR <br />SYSTLI.IS <br />�_LAVATORY <br />(WASH BASIN) <br />I <br />'SHOWER <br />ERSKITCHEN <br />SINK 8 DISP <br />i <br />RYERSDISHWASHER <br />ODLAUNDRY <br />LAUNDRYYPE <br />TRAY <br />'ER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />' <br />' <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />URINAL <br />i <br />FIREPLACE INSERT (WOOD BURNING) <br />DRINKING FOUNTAIN <br />GAS FIREPLACE <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />_r- <br />GAS RANGE <br />' <br />SINK (SERVICE -BAR, ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />i <br />I <br />1 <br />SUB TOTAL £ <br />SUB TOTAL 5 <br />' <br />�— <br />PERMIT £ <br />PERMIT £ <br />TOTAL FEE £ <br />TOTAL FEE £ <br />FOR OFFIGt Ust Urvu: <br />FRONT SETBACK <br />USEZOETAnFA <br />;REAR SETBACK <br />SIDE SETBACK <br />VACANT SITE <br />❑YES ❑ NO <br />PLAN CIIELKNUMBER FEE <br />VALUATION <br />RECEIPTREC.EIPI NO <br />FEE <br />BUILDING <br />�', ('�'L� �•— <br />HEIGHT LIMITATION <br />NO OF DWELLING <br />UNITS <br />SIZE OF BLDG/TI <br />I Z70 e„f f• ] <br />L D %l I <br />PLUMBING <br />' <br />MrCH ICnI. <br />- <br />' <br />OCCUPANCY NO OF STORIES <br />G�wP I <br />l1 <br />OCCUPANT LOAD BASEMENT <br />Ale OYES pJ"NO <br />FVU jVMwT/ <br />ADDITIONAL PUN CHECK <br />7 <br />FIRE SPRINKLER PEGG <br />REASON <br />_ <br />tG`x/�� <br />• <br />OTHER <br />' <br />FIRE ALARM REO'D <br />REASON <br />STATE BUILDING SUHLINnGE <br />PIIDI If. WOnKS <br />TYPE OF C,ONST <br />-TTp 1 <br />..Y-/V <br />PLANS APPROVED BY <br />•VIM <br />DATE A'j <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />